Effectiveness of 2-Dose Vaccination with mRNA COVID-19 Vaccines Against COVID-19–Associated Hospitalizations Among Immunocompromised Adults — Nine States, January–September 2021

Details

• Journal Article:
  Morbidity and Mortality Weekly Report (MMWR)
• Personal Author:
  Embi, Peter J. ; Levy, Matthew E. ; Naleway, Allison L. ; Patel, Palak ; Gaglani, Manjusha ; Natarajan, Karthik ; Dascomb, Kristin ; Ong, Toan C. ; Klein, Nicola P. ; Liao, I-Chia ; Grannis, Shaun J. ; Han, Jungmi ; Stenehjem, Edward ; Dunne, Margaret M. ; Lewis, Ned ; Irving, Stephanie A. ; Rao, Suchitra ; McEvoy, Charlene ; Bozio, Catherine H. ; Murthy, Kempapura ; Dixon, Brian E. ; Grisel, Nancy ; Yang, Duck-Hye ; Goddard, Kristin ; Kharbanda, Anupam B. ; Reynolds, Sue ; Raiyani, Chandni ; Fadel, William F. ; Arndorfer, Julie ; Rowley, Elizabeth A. ; Fireman, Bruce ; Ferdinands, Jill ; Valvi, Nimish R. ; Ball, Sarah W. ; Zerbo, Ousseny ; Griggs, Eric P. ; Mitchell, Patrick K. ; Porter, Rachael M. ; Kiduko, Salome A. ; Blanton, Lenee ; Zhuang, Yan ; Steffens, Andrea ; Reese, Sarah E. ; Olson, Natalie ; Williams, Jeremiah ; Dickerson, Monica ; McMorrow, Meredith ; Schrag, Stephanie J. ; Verani, Jennifer R. ; Fry, Alicia M. ; Azziz-Baumgartner, Eduardo ; Barron, Michelle A. ; Thompson, Mark G. ; DeSilva, Malini B.
• Description:
  Immunocompromised persons, defined as those with suppressed humoral or cellular immunity resulting from health conditions or medications, account for approximately 3% of the U.S. adult population (1). Immunocompromised adults are at increased risk for severe COVID-19 outcomes (2) and might not acquire the same level of protection from COVID-19 mRNA vaccines as do immunocompetent adults (3,4). To evaluate vaccine effectiveness (VE) among immunocompromised adults, data from the VISION Network* on hospitalizations among persons aged ≥18 years with COVID-19-like illness from 187 hospitals in nine states during January 17-September 5, 2021 were analyzed. Using selected discharge diagnoses,| VE against COVID-19-associated hospitalization conferred by completing a 2-dose series of an mRNA COVID-19 vaccine ≥14 days before the index hospitalization date| (i.e., being fully vaccinated) was evaluated using a test-negative design comparing 20,101 immunocompromised adults (10,564 [53%] of whom were fully vaccinated) and 69,116 immunocompetent adults (29,456 [43%] of whom were fully vaccinated). VE of 2 doses of mRNA COVID-19 vaccine against COVID-19-associated hospitalization was lower among immunocompromised patients (77%; 95% confidence interval [CI] = 74%-80%) than among immunocompetent patients (90%; 95% CI = 89%-91%). This difference persisted irrespective of mRNA vaccine product, age group, and timing of hospitalization relative to SARS-CoV-2 (the Virus that causes COVID-19) B.1.617.2 (Delta) Variants predominance in the state of hospitalization. VE varied across immunocompromising condition subgroups, ranging from 59% (organ or stem cell transplant recipients) to 81% (persons with a rheumatologic or inflammatory disorder). Immunocompromised persons benefit from mRNA COVID-19 vaccination but are less protected from severe COVID-19 outcomes than are immunocompetent persons, and VE varies among immunocompromised subgroups. Immunocompromised persons receiving mRNA COVID-19 vaccines should receive 3 doses and a booster, consistent with CDC Rec.(5), practice nonpharmaceutical interventions, and, if infected, be monitored closely and considered early for proven therapies that can prevent severe outcomes.
• Subjects:
  Adolescent Adult Aged Aged, 80 And Over CoronaVirus Infections COVID-19 COVID-19 Vaccines Female Hospitalization Humans Immunization Schedule Immunocompromised Host Laboratories Male Middle Aged SARS-CoV-2 Vaccines, Synthetic Young Adult

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• Source:
  MMWR Morbidity Mortal Weekly Rep. 70(44):1553-1559
• Series:
  Weekly Report: Morbidity and Mortality Weekly Report (MMWR)
• DOI:
  http://dx.doi.org/10.15585/MMWRmm7044e3
• ISSN:
  0149-2195 (print) ; 1545-861X (digital)
• Pubmed ID:
  34735426
• Pubmed Central ID:
  PMC8568092
• Document Type:
  Journal Article
• Place as Subject:
  United States
• Pages in Document:
  7 pdf pages
• Volume:
  70
• Issue:
  44
• Collection(s):
  Morbidity and Mortality Weekly Report (MMWR)
• Main Document Checksum:
  urn:sha-512:ff44aaa578a4f5280051b0f7361c8e3a7926938739604ed47d355a0c3fac035f95298feec33d654a98e8f14f5e7ffddb1bb833df6ecbe07aa67dd085c7dbada2
• Download URL:
  https://stacks.cdc.gov/view/cdc/111850/cdc_111850_DS1.pdf
• File Type:
  [PDF - 146.00 KB ]